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Recurrence rate of shoulder dystocia
D F Lewis1, R C Raymond, M B Perkins
1Department of Obstetrics and Gynecology, Louisiana State University Medical Center, Shreveport 71130-3932, USA.
American Journal of Obstetrics and Gynecology
|May 1, 1995
Summary
Shoulder dystocia recurrence is significantly higher than the initial occurrence rate. Patients with a history of shoulder dystocia experienced a 13.8% recurrence, indicating a need for further investigation into management strategies.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Shoulder dystocia is a significant obstetric complication with known risk factors.
- A history of shoulder dystocia is recognized as a risk factor, but its recurrence rate remains unknown.
Purpose of the Study:
- To determine the recurrence rate of shoulder dystocia in subsequent pregnancies.
Main Methods:
- Retrospective review of an obstetric database from January 1983 to December 1992.
- Identification of vaginal deliveries complicated by shoulder dystocia.
- Analysis of subsequent pregnancies, outcomes, and risk factors for patients with a history of shoulder dystocia.
Main Results:
- The overall rate of shoulder dystocia was 2% (747/37,465 deliveries).
- Among 101 patients with a history of shoulder dystocia, 123 subsequent vaginal deliveries were analyzed.
- Shoulder dystocia recurred in 17 of these subsequent pregnancies, yielding a recurrence rate of 13.8% (p < 0.0001).
Conclusions:
- The recurrence rate of shoulder dystocia is approximately seven times higher than the primary rate.
- Further research is needed to evaluate the potential benefits of elective Cesarean delivery for patients with a history of shoulder dystocia.